Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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Professor and Head
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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

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Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Experimental Research
Year : 2009 | Month : April | Volume : 3 | Issue : 2 | Page : 1466 - 1474

Study Of The Hepatoprotective Activity Of The Ethanolic Extract Of The Pulp Of Eugenia Jambolana (Jamun) In Albino Rats


*MD (Pharmacology), **(Post graduate student, Pharmacology), Dept. of Pharmacology, Assam Medical College & Hospital

Correspondence Address :
Gayatri Sarma, Dept of Pharmacology,
Assam Medical College & Hospital,
Dibrugarh - 786002. Ph : +919435043164.


Objective: To evaluate the hepatoprotective effect of the ethanolic extract of the pulp of Eugenia jambolana (EPEJ) on paracetamol (PCM)-induced hepatotoxicity in albino rats.
Materials and Methods: Healthy albino rats (thirty in number) of either sex, weighing 100-150 gms, were randomly divided into five groups of six animals each. Group A (Normal control) and Group B (Paracetamol-treated control) received 5ml/kg/day of 3% gum acacia; Groups C and D received the ethanolic extract of the pulp of Eugenia jambolana 100mg/kg/day and 200mg/kg/day respectively and Group E received silymarin 100mg/kg/day. All formulations were given orally for ten days. Hepatotoxicity was induced in Groups B, C, D and E by giving a single dose of paracetamol (2gm/kg) orally on the eighthth day of the experiment. Liver function tests (serum levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, total protein and albumin) and the histopathological examination (HPE) of the liver was done for all the five groups on the tenth day.
Statistical Analysis: One-way ANOVA, followed by Dunnett’s multiple comparison test, were used for statistical analysis. Values of p < 0.01 were assumed to be significant.
Results: Group B showed a significant (p<0.01) increase in all serum marker enzymes and total bilirubin and a significant (p<0.01) decrease in total protein, as compared to Group A. In comparison to Group B, Groups C and D showed significant (p<0.01) reduction in the serum levels of all liver enzymes and total bilirubin and an increase in the total protein. HPE studies showed fatty changes, necrosis and fibrosis in Group B, while in Groups C, D and E, histopathology was near normal.
Conclusion: Thus, as revealed by the above study, the ethanolic extract of the pulp of Eugenia jambolana at 100 and 200mg/kg/day, possesses significant hepatoprotective activity in rats induced with hepatotoxin paracetamol.


serummarkerenzymes,paracetamol,hepatoprotective,Eugenia jambolana.

Eugenia jambolana Lam. (Syn. Syzygium cumini Skeels or Syzynium jambolana Dc), belonging to the family Myrtaceae, is a large evergreen tree, up to 30 m high and is widely distributed throughout India, Ceylon-Malaya and Australia (1). The plant is commonly known as Black plum or Jambol (English), Jambavam (Sanskrit), Jamun (Hindi) and Jamu (Assamese). The bark is digestible and is good for bronchitis and asthma. The seed can be used as an astringent and a diuretic and stops urinary discharges. The fruit is a tonic to the liver, it enriches the blood and strengthens the teeth and gums(2). The antidiabetic(3)(4), antibacterial, antifungal (5),(6), antiinflammatory (7) and CNS depressant activities(8) of the plant have already been established. The anti-diarrhoeal (9) and gastric ulceroprotective activities (10) of the plant have also been reported. The hepatoprotective activity of the methanolic extract of the seeds of Eugenia jambolana in streptozotocin-induced diabetic rats has recently been evaluated (11). The phytochemical analysis of the seeds of Eugenia jambolana has revealed the presence of alkaloids, flavonoids, glycosides, phytosterols, saponins, tannins and triterpenoids (12). Fruits of Eugenia jambolana have been reported to contain raffinose, glucose, fructose, citric acid, anthocyanins, mallic acid and gallic acid1. Literature reviews indicated that very few studies on the hepatoprotective potential of this plant, on experimentally induced hepatic damage, have so far been undertaken. From this viewpoint, the present study was aimed at evaluating the hepatoprotective activity of the ethanolic extract of the pulp of Eugenia jambolana against paracetamol-induced hepatotoxicity in albino rats.

Material and Methods

Plant Materials
Fresh, ripe fruits of Eugenia jambolana Lam. were collected from the local market in Dibrugarh in the months from June to August. The plant material was authenticated by Dr. L.R. Saikia, Reader, Department of Life Sciences, Dibrugarh University, Dibrugarh. A voucher specimen (No.DU/LS/207) was deposited at the Department of Life Sciences, Dibrugarh University, Dibrugarh. The pulp of the fruits was manually separated from the seeds, it was air dried and was finely powdered in an electrical mixer grinder. 500 grams of the powdered pulp was soaked in sufficient quantity of 90% ethanol and was allowed to remain for 15 min in a tightly covered container. The entire solution was then transferred to a percolator and enough of 90% ethanol was added to saturate the powder and leave a stratum above it. The top of the percolator was closed and when liquid was about to drip from the apparatus, the lower orifice of the percolator was also closed and the solution was allowed to macerate for 48 hours. Then, percolation was allowed to proceed slowly with sufficient solvent, at a rate not exceeding 1 ml/min, until the drug was exhausted (13) This procedure was repeated twice after full percolation by adding fresh solvent to the previously used drug powder. The extract obtained from percolation was collected in a flask. The extract was flask evaporated by using controlled temperature (bath temperature 40—50 0C) until the solvent part was evaporated (14). The extract was collected in glass petri dishes, further dried in a vacuum dessicator and was finally stored in air tight glass containers in a refrigerator at 2—8 0C for use in the experiments. A final yield of 69.5 grams i.e. 13.9% w/w with respect to the original air dried powder was obtained.

Experimental Animals
Healthy adult Wistar albino rats (Rattus norvegicus) weighing 100—150 grams each were used for the study. The animals were procured from Chakraborty Enterprise, Kolkata, and were maintained at standard housing conditions in the Central Animal House, Assam Medical College and Hospital, Dibrugarh. Housed individually in clean polypropylene cages, the animals were maintained on a standard animal diet and water was provided ad libitum during the entire period of the experiment. The animals were acclimatized to laboratory conditions for five days prior to the experiments. All the animals were taken care of under ethical consideration as per the CPCSEA guidelines (15) with regular inspections of the rats and the laboratory conditions duly undertaken by a registered veterinary practitioner.

Acute Toxicity Study
Acute oral toxicity test for the ethanolic extract of the pulp of Eugenia jambolana Lam. was carried out as per OECD Guideline 425 (16). When administered orally, the seed extract of Eugenia jambolana was found to be non-toxic upto the maximum dose of 2000mg/kg body weight(7),(8). As such, the limit test at 2000 mg/kg, which required the use of only five albino rats, was performed.

One–tenth and one-twentieth of the upper bound dose of the extract from the limit test was decided to be considered for the experiments (17).

Materials Used
 Ethanolic extract of the pulp of Eugenia jambolana (EPEJ).
 Paracetamol (Powder obtained from Bharat Chemicals, Tarapur, Gujarat and standardised as per specifications.)
 Silymarin (Powder obtained from Micro Labs Ltd., Bangalore and standardised as per specifications.)
 3% aqueous suspension of gum acacia.

Evaluation Of Hepatoprotective Activity
The study of the hepatoprotective activity was carried out as described by Chattopadhyay RR et al (18). A total of thirty animals were equally divided into five groups, with six animals in each group. Group A (Normal control) received 3% gum acacia (5ml/kg, orally) for ten days. Group B (Paracetamol-treated control) rats were also given 3% gum acacia (5ml/kg, orally) for ten days and on the eighth day, hepatotoxicity was induced in these rats by giving a single dose of paracetamol (PCM) suspension (2gm/kg, orally) (18) Groups C, D and E were pretreated with EPEJ (100 mg/kg, orally.), EPEJ (200mg/kg, orally.) and Silymarin (100 mg/kg, orally)(19) respectively, for ten days. On the eighth day of the experiment, hepatotoxicity was induced in Groups–C, D, E also, by giving a single dose of paracetamol (PCM) suspension (2gm/kg, orally) (18). The rats were sacrificed under light ether anaesthesia after overnight fasting on the tenth day of the experiment. Blood samples were collected by direct cardiac puncture, into sterilized centrifuge tubes and were allowed to coagulate at room temperature. The serum was separated by centrifugation at 3000 rpm for five minutes (20) and by using Qualigens-Diagnostics Kits manufactured by Sigma Diagnostics (India) Pvt. Ltd., Baroda, alongwith instruments like colorimeter and incubator, biochemical analysis to assess the liver function viz, serum transaminases [aspartate aminotransferase (AST), alanine aminotransferase (ALT)](21), alkaline phosphatase (ALP) (22), total bilirubin (23) and total protein (TP) (24).

Histopathological Study
A portion of the liver tissue of all the animal groups was excised and was then washed with normal saline. The liver tissues were fixed in 10% buffered neutral formalin for 48 hours and then with bovine solution for six hours and were then processed for paraffin embedding. By using a microtome, sections of five mm thickness were taken, were processed in alcohol-xylene series, were stained with alum-haematoxylin and eosin and were subjected to histopathological examination under light microscope using a magnification of 100X (19).

Statistical Analysis
One-way analysis of variance (ANOVA) (25), followed by Dunnett’s multiple comparison test (26), were used for the statistical analysis of the results. The statistical analysis was done using computerised GraphPad Prism software version 5.00. It was assumed to consider values of p < 0.01 to be statistically significant.


Acute Toxicity Test
There was no mortality recorded among the rats upto the maximum dose of 2000 mg/kg (all five animals survived at 2000mg/kg). Hence, the LD50 can be said to be above 2000mg/kg. One-tenth and one-twentieth of the maximum dose tested were selected for the experiments.

Biochemical Assessment
There was a significant (p<0.01) elevation of serum marker enzymes and decrease in total protein and albumin in Paracetamol-treated rats as compared to the rats in the Normal control group, which is an evidence of the extensive liver damage caused by paracetamol. Pretreatment with test drug Eugenia jambolana in both doses (100mg/kg/d and 200mg/kg/d), as well as pretreatment with standard drug Silymarin showed a significant (p<0.01) protective effect by reducing the level of enzymes and by increasing the level of total protein and albumin. The reduction in the level of liver enzymes and increase in the levels of total protein and albumin caused by Eugenia jambolana was dose dependent, the hepatoprotective effect being more with the 200mg/kg dose than with the 100mg/kg dose (Table/Fig 1) .

Histopathological Examination
Histopathological examination of the normal control group under light microscopic magnification of 100X, showed normal hepatocytes (Table/Fig 2). Paracetamol-treated rat liver revealed steatosis, centrilobular necrosis, vacuolisation and fibrosis (Table/Fig 3). Administration of EPEJ preserved the histological structure of the liver to near normal, though there was congestion and regeneration of the liver tissue (Table/Fig 4). The sections of the liver taken from the Silymarin treated group showed a hepatic architecture which was similar to that of the normal control group (Table/Fig 5).


Paracetamol (Acetaminophen) is a widely used antipyretic and analgesic and produces acute liver damage if overdoses are consumed. The hepatotoxicity of paracetamol has been attributed to the formation of toxic metabolites when a part of the paracetamol is activated by hepatic cytochrome P-450 to a highly reactive metabolite N-acetyl-P-benzoquinoneimine (NAPQI) .NAPQI is initially detoxified by conjugation with reduced glutathione (GSH) to form mercapturic acid, which is excreted in urine (27) After a toxic overdose of paracetamol, the quantity and rate of NAPQI formation may overwhelm the capacity of the liver to replenish it’s reduced glutathione stores (28). The NAPQI then causes arylation or oxidation of cytosolic and mitochondrial proteins, leading to their inactivation (29). It also raises the cytosolic calcium levels by inhibiting the calcium-ATPase activity in the plasma membrane and also the mitochondrial calcium uptake and retention (30). This raised cytosolic calcium is responsible for the degradation of adenine nucleotides and the formation of reactive oxygen species. This leads to further oxidation of protein thiols, lipid peroxidation, DNA fragmentation, cell lysis and thus, cell death (29),(31).

In the assessment of liver damage by paracetamol, the determination of enzyme levels such as aspartate aminotransferase (AST/SGOT) and alanine aminotransferase (ALT/SGPT) is largely used. Serum levels of AST, ALT and alkaline phosphatase are the most frequently utilized indicators of hepatocellular injury (32). Necrosis or membrane damage releases the enzymes into circulation; and therefore, they can be measured in serum. ALT is more specific to the liver, and is thus a better parameter for detecting liver injury. Elevated levels of serum enzymes are indicative of cellular leakage and loss of functional integrity of the cell membrane in the liver (33). The mechanism by which alkaline phosphatase reaches the circulation is uncertain; leakage from the bile canaliculi into hepatic sinusoids may result from leaky tight junctions and the other hypothesis is that the damaged liver fails to excrete alkaline phosphatase made in the bone, intestine and the liver (32). Serum total protein, albumin and bilirubin levels, on other hand, are related to the function of hepatic cells i.e they reveal the functional status of the hepatic cells. Decreased levels of total protein and albumin are indicative of the failure of the biosynthetic function of the hepatocyte, while increased levels of bilirubin indicate defective hepatocellular uptake, conjugation and excretion of bilirubin due to the failure of hepatic cell function (32),(34).

In the present study, the paracetamol-treated rats (Group B) showed a significant (p<0.01) elevation in the serum levels of ALT, AST, alkaline phosphatase and total bilirubin, while significantly (p<0.01) decreasing the levels of total protein and albumin as compared to the normal control rats (Group A), thereby indicating liver damage. The paracetamol-induced liver damage was confirmed by the histopathological examination of paracetamol-treated rat liver, which revealed steatosis, centrilobular necrosis, vacuolisation and fibrosis. Administration of EPEJ at doses of 100mg/kg and 200mg/kg, significantly (p<0.01) prevented the rise in the levels of the marker enzymes and total bilirubin, as well as it significantly (p<0.01) prevented the decrease in the serum levels of total protein and albumin. This observation was in conjugation with the histopathological study, which revealed the preservation of the histological structure of the liver to near normal by EPEJ, inspite of slight congestion and regeneration of the liver tissue.

The diminished rise of serum enzymes, together with the diminished fall in the levels of total protein and albumin in the extract (EPEJ)-treated groups, is a clear manifestation of the hepatoprotective effect of the extract. The hepatoprotective effect of Eugenia jambolana was dose dependent i.e. it increased with an increase in dose. Histopathological studies have also provided the evidence of the effect of EPEJ as a hepatoprotectant.

These results indicate the stabilizing effect of EPEJ on the plasma membrane of the hepatocytes, as well as repair of the damaged hepatic tissue, probably brought about by the stimulation of hepatocellular protein synthesis and accelerated regeneration of the hepatocytes. But the major mechanism behind all these effects is probably the diminution of the intensity of oxidative stress induced by paracetamol, which is brought about by the antioxidant activity of EPEJ. The seed kernel of Eugenia jambolana has been reported to increase the hepatocellular reduced glutathione content and also to increase the activities of the antioxidant enzymes glutathione peroxidase, superoxide dismutase and catalase in the liver of experimental animals(35). Since the phytoconstituents of the seed kernel and the pulp of Eugenia jambolana are almost the same, the pulp may also be presumed to have similar effects on antioxidant enzymes. The flavonoids, gallic acid and anthrocyanins present in the pulp of Eugenia jambolana, are natural antioxidants (36). Earlier investigators (37),(38) have screened the hepatoprotective activity of several flavonoid compounds found in plants. Thus, EPEJ, because of the presence of natural antioxidants like flavonoids in it, must have exerted protective action against paracetamol-induced liver damage, probably by increasing the content of reduced glutathione in the blood and liver, which would provide the tissue a better protection against the generation of free radicals, or by increasing the activities of the antioxidant enzymes like superoxide dismutase and thereby scavenging the already generated free radicals. This must have ameliorated the extent of oxidative stress mediated cellular damage caused by paracetamol.

Thus, it can be concluded that the ethanolic extract of the pulp of Eugenia jambolana possesses a significant hepatoprotective effect. However, further studies to establish the exact mechanism of the hepatoprotective action have to be undertaken. Also, studies for isolating and elucidating the structure of the active principles responsible for the hepatoprotective action that are present in the pulp of Eugenia jambolana, can be undertaken.

Key Message

The fruit of Eugenia jambolana is considered to be a ‘tonic to the liver’ in traditional Yunani medicine. Very few studies have been done to validate this fact and so the present study was undertaken to evaluate its hepatoprotective activity.


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